In 1954 Charles Bukowski spent nine days in LA County Hospital being treated for an internal hemorrhage (a bleeding ulcer). When writing about the incident later, he claimed that he nearly died due to the negligence and apathy of the staff. You might think that's just a writer being dramatic, but this article from the Los Angeles Times that was printed a few years after Bukowski's hospitalization would seem to indicate that he wasn't exaggerating.

The Los Angeles Times

Paul V. Coates - Confidential File

September 5, 1957

On my desk are some 200 letters, each charging County General Hospital with neglect, indifference and cruelty.

They were sent to me by former county patients following my recent reports--both in this column and on television--of some frightening conditions which existed, and still exist, in the institution. I believe that the letters were written by sincere people. But I'm not going to print them. I'm not, because I don't think it would benefit anyone.

Instead, I'm going to print excerpts from a letter written by a doctor currently employed at General Hospital. For obvious reasons, I'm not mentioning his name.

The morning following your latest report there was quite a buzz in the hospital halls. The consensus of opinion among the doctors was that the conditions which you presented are essentially true. Of course, there are the usual number of cranks who are unhappy even when they receive the best of charity, but it is true that many patients here are neglected. The Civil Service bureaucracy is to a great extent the cause.

But the bureaucracy is made up of individual people who are subject to human traits of the sort which have produced the problem. Complex as it is, I will attempt to analyze the problem. The following, I believe, are the reasons and contributing factors for poor patient care at the hospital:

1--Attitude of the employees toward the patients.
It is no secret that many employees are actually aggressive toward patients. Remarks and conversations can be heard daily, on every floor of the building, which are resentful of the patients being there.

2--Not enough help in certain key locations where the patient load is always heavy.
The admitting room is always crowded and help is insufficient. The X-ray department is another bottleneck.

3--The hospital facilities are many times overburdened with ineligible patients who seek free medical care.
Perhaps these patients are considered eligible by the Social Service Department, but any outsider who knew their true circumstances would say 'No' to their receiving free medical care. This should also include those able to work, but too lazy. Why should they work when charity is so easy to obtain?

It brings to mind the actual case of a bum who lived by drifting from charity hospital to charity hospital. He had learned to malinger by describing certain symptoms which experience had taught him would prompt the doctor to keep him in the hospital for observation. He could tell you how the service was in New Orleans, how the food was in Chicago, and so forth.

4--The type of personnel which applies for Civil Service jobs.
Time killers often find a good place to kill time in Civil Service. Many employees are putting in time waiting for retirement. It's difficult to fire a poor employee. This would require close watching to prove incompetence. The close watching would of necessity be done by a superior--an older employee who was even closer to retirement, and perhaps an even better time killer with more experienced years of loafing behind him. A situation like this naturally tends to drive the more competent help away from the hospital.

5--Poor supervision of employees by superiors.
Laxity in duties goes uncorrected. The chain of authority in many departments is so broken up that it just doesn't exist in an effective form.

In summing up, I should say that while the problem at the hospital is not new, it seems to be getting worse, rather than better. Much of the careless attitude of the lazy employee is learned by other employees and so the contagion spreads unabated.

The doctor's views aren't completely shared, of course, by County General Hospital's administrators. Tomorrow I'll report the hospital's faults, problems and needed corrective measures as seen by the men in charge.